Cedars-Sinai Medical Center

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A BI-WEEKLY PUBLICATION FROM THE CEDARS-SINAI CHIEF OF STAFF April 13, 2012 Issue | Archived Issues

Cedars-Sinai is LA's only cancer center to receive national achievement award for patient care

Cedars-Sinai's Samuel Oschin Comprehensive Cancer Institute is the only cancer center in Los Angeles to receive a Commission on Cancer 2011 Outstanding Achievement Award for providing quality care and services to cancer patients. Less than 10 percent of the nation's 1,400 currently accredited and newly accredited cancer programs surveyed this year received the Outstanding Achievement Award from the Commission on Cancer.

» Read more

Cedars-Sinai Heart Institute ranked first nationally in 2011 adult heart transplants

For the second year in a row, the Cedars-Sinai Heart Institute and Comprehensive Transplant Center performed the most adult heart transplants of any U.S. medical center, according to government statistics.

» Read more

CS-Link IP3 update

South Tower Physician Resource Center open through April

Learn about the latest updates, reminders, training and assistance information.

» Read more

Want a role on the Medical Executive Committee?

Submit your petition for a member-at-large position by May 4

Membership on the Medical Executive Committee includes five positions for "members-at-large," each serving a term consisting of two years. Three of these spots will become open on Jan. 1, 2013, and are available to be filled by interested and eligible members of the medical staff.

» Read more

Antimicrobial stewardship progress report

Pharmacy focus

Last year, the Antimicrobial Utilization Review Committee and the Pharmacy and Therapeutics Committee approved expanding the number of antibiotics with a five-day stop date to all antimicrobials (with exceptions, including a number of agents utilized in prophylactic regimens and non-ID related uses). This change will go into effect within the next several weeks. As is the current practice, physicians will be notified via alerts that an antimicrobial will expire.

» Read more

Yom Ha'Shoah program planned for April 23

Author Daniel Jonah Goldhagen will speak at Cedars-Sinai's 28th annual Yom Ha'Shoah commemoration on Monday, April 23. The event will be held in Harvey Morse Auditorium from 11:50 a.m. to 1 p.m.


» Read more

A longstanding commitment to making our community stronger

President's Perspective

In one of many letters from grateful patients that cross my desk, a woman who faced a serious illness just after being laid off from her job and losing her health insurance wrote to thank the many individuals at Cedars-Sinai who "... without meeting me, or knowing much about me, came to my aid and offered help in the same way that a family member or a good friend would offer love and support in a difficult time."

» Read more

Circle of Friends honorees for March

The Circle of Friends program honored nearly 200 people in March. Circle of Friends allows grateful patients to make a donation in honor of the physicians, nurses, caregivers and others who have made a difference during their time at Cedars-Sinai.

» Read more

Researchers identify drugs with fewest side effects for treating IBS

Cedars-Sinai researchers have determined that two prevalent drug therapies - rifaximin and lubiprostone - offer some of the best options for treating irritable bowel syndrome, a widespread disorder that affects up to one in five Americans. The findings, based on an analysis of more than two dozen large-scale clinical trials, are contained in a peer-reviewed study published online by The American Journal of Medicine and set to appear in the publication’s April print edition.

» Read more

Cedars-Sinai is LA's only cancer center to receive national achievement award for patient care

Cedars-Sinai's Samuel Oschin Comprehensive Cancer Institute is the only cancer center in Los Angeles to receive a Commission on Cancer 2011 Outstanding Achievement Award for providing quality care and services to cancer patients.

Less than 10 percent of the nation's 1,400 currently accredited and newly accredited cancer programs surveyed this year received the Outstanding Achievement Award from the Commission on Cancer, a national consortium of more than 45 professional organizations dedicated to improving survival rates and quality of life for cancer patients through research, education, prevention and quality management. The 2011 Outstanding Achievement Award recipients were just announced by the commission.

"Cancer patients deserve the best healthcare, and this designation demonstrates our commitment to fulfilling their needs," said Steven Piantadosi, MD, PhD, director of the Samuel Oschin Comprehensive Cancer Institute and Phase One Foundation Chair.

Established in 2004, the Commission on Cancer Outstanding Achievement Award is granted to facilities that demonstrate a Commendation level of compliance with seven standards that represent six areas of cancer program activity: cancer committee leadership, cancer data management, clinical management, research, community outreach and quality improvement.

Only 30 percent of the nation's hospitals are commission accredited. As a commission-accredited cancer program, Cedars-Sinai's Samuel Oschin Comprehensive Cancer Institute provides its patients with access to the most current clinical trials, newest treatment options, comprehensive and multidisciplinary care, as well as the latest equipment and services. To maintain accreditation, facilities with Commission on Cancer-accredited cancer programs must undergo an on-site review every three years.

Cedars-Sinai's Samuel Oschin Comprehensive Cancer Institute is known for combining the highest quality patient care and the latest advances in cancer research. Its outpatient cancer center treats more than 9,000 patients each year, making it one of the busiest treatment facilities in California. The institute's cancer program was deemed one of the top in the country in U.S. News & World Report's 2010-11 "Best Hospitals" issue.

Cedars-Sinai Heart Institute ranked first nationally in 2011 adult heart transplants

For the second year in a row, the Cedars-Sinai Heart Institute and Comprehensive Transplant Center performed the most adult heart transplants of any U.S. medical center, according to government statistics.

In 2011, Cedars-Sinai surgeons performed heart transplants on 87 patients and heart and lung transplants on two patients, making the Cedars-Sinai Heart Institute the leader among the 116 U.S. medical centers that performed adult heart transplants that year. The official statistics were compiled by the United Network for Organ Sharing, the nonprofit organization that manages the nation's transplant system.

"Cedars-Sinai's commitment to the patient with advanced heart failure is unmatched," said Eduardo Marbán, MD, PhD, director of the Cedars-Sinai Heart Institute and the Mark S. Siegel Family Professor. "We are the No. 1 heart transplant program in the world; our outcomes are superior; we have a dedicated inpatient unit specializing in pre- and post-transplant care; and we continue to develop new stem cell-based approaches as future alternatives to transplantation and devices."

During the previous year at the Cedars-Sinai Heart Institute, 75 heart transplant patients and one heart-and-lung transplant patient received new organs. Since 1988, when the Heart Transplant Program was established, 741 patients have undergone heart transplantation.

"Providing the highest quality care for patients with heart, liver, kidney, pancreas, or lung failure is an institutional priority," said Andrew S. Klein, MD, MBA, director of the Cedars-Sinai Comprehensive Transplant Center and the Esther and Mark Schulman Chair of Surgery and Transplant Medicine. "The collaborative efforts of more than 300 doctors, scientists and staff within the Comprehensive Transplant Center have been life-saving and quality of life improving for rapidly growing numbers of patients at Cedars-Sinai. The opportunity to be a part of this transformative process is a gift."

Jon Kobashigawa, MD, director of the Heart Transplant Program and the DSL/Thomas D. Gordon Chair in Heart Transplantation Medicine, said, "Every physician, nurse and researcher on our team has a deep commitment to achieve continued excellence in heart transplantation. We all share the feeling that it is an honor to help our patients have a second chance at life."

The new heart transplant statistics underscore the Cedars-Sinai Heart Institute's tradition of expertise and innovation, dating back to the 1920s, when Los Angeles' first electrocardiogram machine was installed. In the 1950s, Cedars-Sinai doctors were first to use thrombolytic enzymes to dissolve blood clots in the heart and were first to describe vasopastic angina syndrome. In 1970, two Cedars-Sinai physicians invented the Swan-Ganz catheter, still used today to measure blood flow and heart pressure.

In recent years, the Cedars-Sinai Heart Institute has undergone rapid growth. After Marbán became the institute's director in 2007, the addition of heart rhythm expert Sumeet S. Chugh, MD, hypertension specialist Ronald Victor, MD, and advanced heart failure specialist Kobashigawa rounded out the Institute's senior leadership.

In November 2011, Marbán published results from a groundbreaking clinical trial that showed treating heart attack patients with an infusion of their own cardiac stem cells helped damaged hearts re-grow healthy muscle. Patients who underwent the stem cell procedure pioneered by Marbán demonstrated an average of 50 percent reduction in the size of the scar left on the heart muscle by a heart attack. Patients also experienced a sizable increase in healthy heart muscle following the experimental stem cell treatments.

Other path-breaking programs include: research by P.K Shah, MD, who is developing novel gene therapy approaches to protect against heart attacks and strokes; the unified approach to women's heart problems pioneered by Noel Bairey Merz, MD, director of the Women's Heart Center; and innovative endovascular interventional cardiology directed Raj Makkar MD. Cedars-Sinai interventional cardiologists participating in clinical trials have performed more catheter-based aortic valve replacement and mitral valve repair procedures than doctors in any other U.S. program.

In 2010, the Heart Institute opened an innovative, first-in-California, 30-bed Advanced Heart Failure in-patient unit dedicated to providing an intensive, multidisciplinary approach to inpatient care.

CS-Link IP3 update

The Physician Resource Center (South Tower, Plaza Level, Room 2806) will remain open through April.

Decision Support Pilot

  • A Clinical Decision Support pilot is underway to support clinicians caring for patients with congestive heart failure and acute myocardial infarction on 5NE, 5NW and 6SE. Please offer your feedback on these tools at cshelp@cshs.org.

Protocol Orders

  • Hospital protocol orders such as MDRO screens and immunization notifications require physician co-signature. Please co-sign these orders in your "In Basket."

A lot of improvement has occurred in CS-Link™!

  • We continue to improve the formatting of the "Facesheet." You should be seeing new formatting soon to bring back the style that physicians have been used to.
  • APACHE (clinical severity scoring system) went live in the MICU on April 9. Training on its use is available. Go to the Physician Resource Center in the South Tower, Plaza Level, Room 2806.
  • Diagnosis association with medication will be disabled pending improved programming from EPIC.

Reminders

  • To addend a dictated note in CS-Link, go to the "Notes" activity and click "Addendum" while your note is highlighted. If you co-signed a trainee's note, click on "edit." You may find that the best way to access these notes, particularly if the encounter has ended, is by using the "In Basket" to look at "done'd" notes (available as a "Public Favorite Search" in your "In Basket").
  • When discharging a patient consider getting the "Discharge SWAT Team" to help. Available through the Physician Resource Center in Room 2806 or by calling ext. 3-2828.
  • For OB physicians:
    • Remember to use your transfer navigator for every level of change of care, and please remember to do order and medication reconciliation.
    • All circumcision orders, including consent, to be accessed from the baby's chart.

Training updates

In an effort to provide physicians with ongoing training, we have new workshops available. Please visit www.cslinkcentral.org and look under "Upcoming Events" for details.

Need help with CS-Link?

You can seek out a CS-Link expert (wearing a red shirt) or a Super User, call the dedicated physician phone line at ext. 3-2828 (option 3), or send an email to cshelp@cshs.org.

CS-Link Go-Live for Physicians - April 9, 2012 (PDF)

Want a role on the Medical Executive Committee?

Submit your petition for a member-at-large position by May 4

Membership on the Medical Executive Committee includes five positions for "members-at-large," each serving a term consisting of two years. Three of these spots will become open on Jan. 1, 2013, and are available to be filled by interested and eligible members of the medical staff.

The Medical Staff Bylaws and Medical Staff Rules and Regulations describe the requirements and the steps needed to be considered a candidate for a member-at-large position. The relevant sections from these documents have been excerpted and can be found at the following Medical Staff Intranet page:
http://web.csmc.edu/medical-staff/elections---terms-expiring--governing-rules.aspx.

You must fulfill the criteria listed in Section 22.1 of the Rules & Regulations. Click the following link to view a PDF:

Criteria for Eligibility for Election to the Executive Committee (PDF)

If you do not fulfill these criteria, you will not be eligible for candidacy.

Please note that a conflict of interest questionnaire needs to be submitted prior to the publication of the final ballots. Click here to either confirm that you have submitted a conflict of interest questionnaire for this year or complete the document online. If you need assistance or have never submitted a questionnaire and need a log-on ID,please call Internal Audit at (323) 866-6900.

The official forms for the petitions to establish candidacy are now available at the Medical Staff Office. Completed petitions accompanied by a statement of qualifications- based on the eligibility criteria of Section 22.1 – must be submitted to the Medical Staff Office no later than 5 p.m., Friday, May 4, 2012. The Medical Staff Office is located on the North Plaza Level, Room 2211, and can be reached by calling (310) 423-5154.

If you have further questions about the election procedure, please email David Kulber, MD, medical staff secretary, at KulberD@cshs.org.

Antimicrobial stewardship progress report

Pharmacy focus

Promoting appropriate antimicrobial selection, dose, route of administration, and duration are integral components of a continuing initiative to promote antimicrobial stewardship and reduce resistance to drugs. Duration of therapy has been a recent area of focus.

Since December 2009, specificbroad spectrum gram-negative active antibiotics (piperacillin/tazobactam, cefepime, imipenem, meropenem, levofloxacin and ciprofloxacin) have been assessed a five-day automatic stop date, with alerts provided to notify physicians that the antibiotic will expire.

Last year, the Antimicrobial Utilization Review Committee and the Pharmacy and Therapeutics Committee approved expanding the number of antibiotics with a five-day stop date to all antimicrobials (with exceptions, including a number of agents utilized in prophylactic regimens and non-ID related uses). This change will go into effect within the next several weeks. As is the current practice, physicians will be notified via alerts that an antimicrobial will expire.

Ongoing promotion of antimicrobial stewardship is embedded in Cedars-Sinai's Patient Safety Goal of reducing antimicrobial resistance. These efforts also are in compliance with the California Department of Public Health's Antimicrobial Stewardship Program Initiative as well as the mandates of state Senate Bill 739, stating "general acute care hospitals monitor and evaluate the utilization of antibiotics and charge a quality improvement committee with the responsibility for oversight of the judicious use of these medications."

Yom Ha'Shoah program planned for April 23

Author Daniel Jonah Goldhagen will speak at Cedars-Sinai's 28th annual Yom Ha'Shoah commemoration on Monday, April 23. The event will be held in Harvey Morse Auditorium from 11:50 a.m. to 1 p.m.

Goldhagen's first book - "Hitler's Willing Executioners: Ordinary Germans and the Holocaust" - was published in 15 languages, recognized by Time magazine as one of the two best non-fiction works of the year and resulted in the author receiving Germany's prestigious Democracy Prize.

Goldhagen will be introduced by Joel Geiderman, MD, co-chair of the Emergency Department and chair of the Holocaust Remembrance Day Program at Cedars-Sinai. He also is a member of the United States Holocaust Memorial Council.

Following Goldhagen's presentation, candles will be lit to remember the 6 million Jews killed in the Holocaust.

The program will conclude with the reciting of El Moleh Rachamin by Cantor Netanel Baram and Senior Rabbi Jason Weiner, manager of Spiritual Care, leading the Mourner's Kaddish.

Holocaust Remembrance Day, known as Yom Ha'Shoah in Hebrew, is commemorated across the globe on the 27th of Nisan. This date, set on the Hebrew lunar calendar, causes the corresponding date on our solar Gregorian calendar to fluctuate slightly each year.

A longstanding commitment to making our community stronger

Thomas M. Priselac
President and CEO

In one of many letters from grateful patients that cross my desk, a woman who faced a serious illness just after being laid off from her job and losing her health insurance wrote to thank the many individuals at Cedars-Sinai who "...without meeting me, or knowing much about me, came to my aid and offered help in the same way that a family member or a good friend would offer love and support in a difficult time."

One of our social workers had walked this patient through the process of applying for financial assistance to help pay her hospital bills. As part of Cedars-Sinai's multifaceted, far-reaching Community Benefit commitment, we offer free or significantly discounted care to those who qualify, relieving patients' financial stress so they can focus on healing.

It's second nature for Cedars-Sinai to express compassion in tangible ways like this - part of our DNA as a nonprofit academic medical center with deep roots in this community. From Cedars-Sinai's beginning more than a century ago, we've addressed our community's healthcare needs with a special sensitivity to those who are most vulnerable. And in times like this, when a prolonged economic downturn has left more people living on the edge, our role in expanding access to healthcare becomes even more critical.

In the course of my interactions with community leaders who partner with us to improve health in underserved neighborhoods of Los Angeles, I often hear stories of how our medical staff and employees are making a difference in people's lives. Your personal contributions are seen and greatly appreciated, within our organization and in our community. Thanks to your individual and collective efforts, Cedars-Sinai has earned a reputation as an organization with a passion for helping others that extends far beyond our campus.

Addressing the community's most serious health issues

In FY 2011, Cedars-Sinai's financial contribution to Community Benefit totaled $600.6 million. This encompasses traditional charity care, the unreimbursed cost of caring for Medicare and Medi-Cal patients and biomedical research that leads to major medical advances. We also train future healthcare professionals and offer hundreds of programs in the community through which we share our expertise and resources to help people lead healthier lives. We provide free health education, screenings and medical services at schools, community centers and clinics where we can connect with at-risk children and seniors, the homeless and the mentally ill, among many others.

Based on the community needs assessment we conduct every three years, obesity, diabetes and heart disease are among the biggest health issues in the Los Angeles region, so many of our programs are aimed at helping people prevent or manage these conditions. We're also working to overcome disparities in health status and disease risk among people of different ages and racial and ethnic backgrounds in a region that is one of the most diverse in the nation.

People from all walks of life benefit from our efforts to make our community stronger. While Cedars-Sinai is known to some as the hospital of the stars, in reality the rich and famous represent a very small fraction of the people we serve. In fact, nearly half the households within a 10-mile radius of Cedars-Sinai earn less than $35,000 a year.

We work closely with schools, community centers, homeless shelters, places of worship, senior centers, local government and other partners with first-hand knowledge of community needs, providing support in ways that expand their capabilities and maximize the impact of our joint efforts.

A broad-based approach with far-reaching benefits

For some families in our community, the benefits of these efforts have spanned multiple generations. For example, a mother of three in Watts remembers visiting Cedars-Sinai's COACH for Kids and Their Families® mobile medical van in her neighborhood on numerous occasions when she was growing up. Now she brings her children to COACH for healthcare - to the same nurse practitioner who looked after her when she was a teen-ager.

Among other ways in which we expand access to healthcare for those in greatest need is through our Emergency Department and Level I trauma center, our Ambulatory Care Clinic and the involvement of our medical residents in caring for patients at free clinics around Los Angeles.

Each year, we also participate in many health fairs where our nurses provide education and screening for high blood pressure, diabetes, breast cancer and other medical conditions, as well as flu shots for the elderly and other at-risk individuals.

Getting children started on a lifetime of good health is one of our top priorities, and our community health educators have a growing presence in Los Angeles elementary schools where they provide lessons on nutrition and fitness through ongoing Healthy Habits for Kids workshops. This program is offered primarily in underserved neighborhoods of Mid-City, Koreatown and Hollywood.

We reach out to disadvantaged teen-agers, too, helping to broaden their future opportunities - and strengthen the healthcare workforce - through programs such as Youth Employment & Development (YED), which brings Fairfax High School students to Cedars-Sinai in their junior and senior years. Over the years, many of you have mentored these students and helped them learn job skills. A high percentage of YED students finish college and end up pursuing careers in the healthcare field, and some have even returned to Cedars-Sinai to work full time after finishing their education.

Also part of our broad efforts to improve community health is a $1.5 million grant program to support nonprofits that provide direct, community-based mental health services for underserved populations.

I could provide many more examples of how we express our extraordinary commitment to community service, but it's more important to thank you for everything you do to help our neediest neighbors lead longer and more fulfilling lives. Your day-to-day efforts - and Cedars-Sinai's overall Community Benefit contribution - will have a positive impact on our community for many decades to come, as one generation after another benefits from better health.

Click here to read past President's Perspective columns.

Circle of Friends honorees for March

The Circle of Friends program honored nearly 200 people in March.

Circle of Friends allows grateful patients to make a donation in honor of the physicians, nurses, caregivers and others who have made a difference during their time at Cedars-Sinai. When a gift is made, the person being honored receives a custom lapel pin and a letter of acknowledgement.

Click here for more information about the program and for a list of past honorees.

  • Azieb T. Abraham
  • Carrie Langhans
  • Bessie Adams
  • Babak Larian, MD
  • Eloisa R. Aguilar
  • Stephanie Lau, RN-BC, BSN
  • Michelle Amarillas, RN, CEN, MICN
  • Irving Lebovics, DDS
  • Neel Anand, MD
  • Roger L. Lerner, MD
  • Alexandra L. Anderson, MD
  • Ronald Leuchter, MD
  • Thomas Apostle, DO
  • Andrew Li, MD
  • M. William Audeh, MD
  • Michael C. Lill, MD, BS
  • Mark J. Ault, MD
  • Stephen W. Lim, MD
  • David Austin, MD
  • Christine A. Limon
  • Valentina Ayvazova, RN, CN
  • Angela M. Lopez, MD
  • C. Noel Bairey Merz, MD
  • Marsia Lopez, RN
  • Page Bertolotti, RN, BSN, OCN
  • Susan Lowenbraun, RN, BSN, OCN
  • Parag Bharadwaj, MD
  • Mariefe Macagba-Castro, RN
  • Kade T. Birkeland, PharmD
  • James MacDonald, RN, BSN, MPH
  • Keith Black, MD
  • Rajendra Makkar, MD
  • Clifford Bochner, MD
  • Adam Mamelak, MD
  • Emmanuel Brandeis, MD
  • Hasmik Martirosyan
  • Earl W. Brien, MD
  • Robert McKenna, Jr., MD
  • Eileen Brown, OCN, RN
  • Shlomo Melmed, MD
  • Neil A. Buchbinder, MD
  • Dorothy T. Melvin
  • Mathew H. Bui, MD
  • Leslie Memsic, MD
  • Ilana Cass, MD
  • Steven A. Miles, MD
  • David Chang, MD
  • Patricia A. Mitchell
  • Dorrie Chang, MD
  • Charles Moon, MD
  • Kirk Y. Chang, MD
  • Esther Morrison, RN
  • Allen S. Chroman, MD
  • Youram Nassir, MD
  • Ray M. Chu, MD
  • Ronald B. Natale, MD
  • Andrew Chuang, MD
  • Christopher S. Ng, MD
  • Alice P. Chung, MD
  • Nicholas Nissen, MD
  • Geemee Chung, MD
  • Thasana Nivatpumin, MD
  • Jason S. Cohen, MD
  • Adrian G. Ostrzega, MD
  • Martin Cooper, MD
  • Samantha Padre, RN, BSN
  • Stephen T. Copen, MD
  • Guy D. Paiement, MD, MBA
  • Kenneth A. Corre, MD
  • John Pappas, LCSW
  • Ruth Cousineau, MD
  • Arlene Parker, RNC, MS
  • Alice Cruz, MD
  • Jignesh K. Patel, MD, PhD
  • Catherine M. Dang, MD
  • Jeremy S. Perlman, MD
  • Alfredo De Los Santos, RN
  • Brian Perri, MD, DO
  • Robert W. Decker, MD
  • Cheri Phillips, MPA-C
  • Rick B. Delamarter, MD
  • Surasak Phuphanich, MD
  • Alice R. Dick, MD
  • Jana Posalski, MD
  • Noam Z. Drazin, MD
  • Jose Ramirez
  • J. Kevin Drury, MD
  • Danny Ramzy, MD, PhD
  • Marla C. Dubinsky, MD
  • Srikanth S. Rao, DO
  • Michael Duffy, MD
  • Jeffrey Rapp, MD
  • Brenda J. Durand, RN, CCTC
  • Alexandre Rasouli, MD
  • Karyn Eilber, MD
  • Toni Reed, RN, BC
  • Yaron Elad, MD
  • Barry E. Rosenbloom, MD
  • Fardad Esmailian, MD
  • Paula Rubin, BS
  • Edward J. Feldman, MD
  • Jeremy Rudnick, MD
  • David A. Feldmar, MD
  • Paul Rudnick, MD
  • Phillip R. Fleshner, MD
  • Vivian Salle, CN
  • Charles Forscher, MD
  • Srinath Samudrala, MD
  • Gerhard Fuchs, MD
  • Gregory Sarna, MD
  • Erwin Peter Gabor, MD
  • Jay Schapira, MD
  • Steven S. Galen, MD
  • Wouter I. Schievink, MD
  • Seda M. Gharapetian, RN
  • Prediman K. Shah, MD
  • Armando E. Giuliano, MD
  • Michael M. Shehata, MD
  • Richard N. Gold, MD
  • Chrisandra L. Shufelt, MD, MS
  • Leo Gordon, MD
  • Robert J. Siegel, MD
  • Richard E. Gould, MD
  • Allan W. Silberman, MD, PhD
  • Steven B. Graff-Radford, DDS
  • Amanuel Sima, MD
  • Stephen Graham, MD
  • Liliana Sloninsky, MD
  • Paula M. Grandbois, RN, CNOR, RNFA
  • Jason Snibbe, MD
  • Leland M. Green, MD
  • Karyn Morse Solky, MD
  • Lloyd B. Greig, MD
  • Richard Sokolov, MD
  • Hope Gruendler, RN, MSN, CNRN
  • Jasminka Stegic, MS, ANP-BC, CCRN
  • Paul Hackmeyer, MD
  • Jerrold H. Steiner, MD
  • Antoine Hage, MD
  • Bryna Stewart
  • Michele A. Hamilton, MD
  • Daniel Stone, MD, MPH, MBA
  • Michael D. Harris, MD
  • Lucille I. Supall
  • Randy Harris, MD
  • Nicholas R. Szumski, MD
  • Jonathan Helali, MD
  • Michele Tagliati, MD
  • Theresa C. Henderson, MD
  • Shirin Towfigh, MD
  • Arash Horizon, MD
  • Debbie Tran, PA-C
  • Erica T. Horn
  • Tram T. Tran, MD
  • Robin R. Hudson, RN, CPAN
  • Alfredo Trento, MD
  • Gabriel Hunt, Jr., MD
  • Diane Tryciecky, RN
  • Leonel Hunt, MD
  • Timothy Tsui, MD
  • Asma Hussaini, MS, PA-C
  • Hannah T. Tualla, RN, MSN, NP-C
  • Nhung H. Huynh, RN
  • David M. Ulick, MD
  • Ashley Jackson
  • Suketu B. Vaishnav, MD
  • J. Patrick Johnson, MD
  • Eric Vasiliauskas, MD
  • David Y. Josephson, MD
  • Robert A. Vescio, MD
  • Colleen C. Juban, RN
  • Rafael Villicana, MD
  • Peter Julien, MD
  • Liwayway Walde, RN-BC, BSN
  • Saibal Kar, MD
  • Ayanna Miyako Walden, MD
  • Beth Y. Karlan, MD
  • Christine S. Walsh, MD
  • Ronald Karlsberg, MD
  • Mark A. Weissman, DPM
  • David Kawashiri, MD
  • Courtney L. Williams, RN
  • Ilan Kedan, MD, MPH
  • Robert N. Wolfe, MD
  • Kathleen Kelley-Smith, RN
  • Edward Wolin, MD
  • Walter F. Kerwin, MD
  • Philip Yalowitz, MD
  • Ali Khoynezhad, MD
  • Clement C. Yang, MD
  • Howard H. Kim, MD
  • John Yu, MD
  • Asher Kimchi, MD
 
  • Jon A. Kobashigawa, MD
 
  • Michael A. Kropf, MD
 
  • Cecilia K. Lam
 

For more information, contact Cynthia Lopez at ext. 6-6217.

Researchers identify drugs with fewest side effects for treating IBS

Cedars-Sinai researchers have determined that two prevalent drug therapies - rifaximin and lubiprostone - offer some of the best options for treating irritable bowel syndrome, a widespread disorder that affects up to one in five Americans. The findings, based on an analysis of more than two dozen large-scale clinical trials, are contained in a peer-reviewed study published online by The American Journal of Medicine and set to appear in the publication’s April print edition.

Patients with irritable bowel syndrome often experience abdominal pain or cramps, excess gas or bloating and visible abdominal distension. Many drug therapies cause troubling side effects of their own, including nausea, insomnia, palpitations and decreased appetite.

"For the millions of patients who suffer from IBS, effective treatment options have been very scarce," said Mark Pimentel, MD, a lead author of the study and director of the Gastrointestinal Motility Program and Laboratory.

Pimentel and the other researchers analyzed common treatments for IBS.

For diarrhea forms of the condition, they evaluated tricyclic antidepressants; alosetron, a drug that slows movement of stool in the gut; and rifaximin, an antibiotic that stays in the gut and is currently FDA-approved to treat traveler’s diarrhea and hepatic encephalopathy.

For constipation forms of IBS, the researchers examined antidepressants known as serotonin reuptake inhibitors and lubiprostone, a drug that promotes gut secretion.

The research found striking differences:

  • For every 2.3 patients who benefited from tricyclic antidepressants, one suffered harmful side effects and had to stop taking the medication.
  • For every 2.6 patients helped by alosetron, one had to halt the drug.
  • By contrast, for every 846 patients aided by rifaximin, one had to discontinue the medication.
  • Lubiprostone and serotonin reuptake inhibitors demonstrated a complete lack of "harm" to IBS patients with constipation, as defined by the study.

"We found that rifaximin and lubiprostone have the lowest level of harmful side effects of all the well-studied drug therapies for IBS," Pimentel said.

"This underscores the need for us to continue to monitor new therapies for this disease," Pimentel added. "While it is important to see benefit with drugs, harm is something we do not often assess well."

Besides Cedars-Sinai, other centers participating in the research included the School of Medicine at Texas Tech University’s Health Sciences Center; the UCLA Department of Medicine; Beth Israel Deaconess Medical Center; and Harvard Medical School.

Funding for the study was provided by the Beatrice and Samuel A. Seaver Foundation.